Curative resection with endoscopic submucosal dissection of early gastric cancer in -negative Ménétrier's disease: A case report.

Background: Adult-onset Ménétrier's disease is strongly associated with () infection and an elevated risk of carcinogenesis. Cases of early-stage gastric cancer developed in -negative Ménétrier's disease are extremely rare. We report a case of early gastric cancer in -negative Ménétrier's disease that was curatively resected with endoscopic submucosal dissection (ESD).

Case Summary: A 60-year-old woman was referred to our hospital after her medical examination detected anemia. Contrast-enhanced upper gastrointestinal (UGI) radiography revealed translucency of the nodule-aggregating surface with giant rugae. Blood tests showed hypoproteinemia and were negative for serum immunoglobulin G antibodies. The Tc-DTPA-human serum albumin scintigraphy showed protein loss from the stomach. UGI endoscopy showed a 40-mm protruding erythematous lesion on giant rugae of the greater curvature of lower gastric body, suggesting early-stage gastric cancer due to Ménétrier's disease. resection with ESD was performed for diagnosis and treatment. Histology of ESD showed well-differentiated tubular adenocarcinoma. The cancer was confined to the mucosa, and complete curative resection was achieved. Foveolar hyperplasia and atrophy of the gastric glands were observed in non-tumor areas, histologically corresponding to Ménétrier's disease. Three years after ESD, gastric cancer had not recurred, and Ménétrier's disease remained in remission with spontaneous regression of giant gastric rugae.

Conclusion: Complete curative resection was achieved through ESD in a patient with early-stage gastric cancer and -negative Ménétrier's disease.